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Last night I went to work and was informed that I was to float to a certain unit. It wasn’t my turn to float, and I said so pretty strongly, but I had to go. When I got to the unit I was told to go to, I couldn’t find anyone to tell me where to go or who to get report from. They didn’t seem to be expecting me. The supervisor came up and I reiterated that it wasn’t my turn to be pulled and I wasn’t happy, and that this particular unit wasn’t expecting me. She called staffing, who said I was indeed supposed to be there. But she got all defensive and said she would go look in the “pull book” on my unit. I said never mind, I’m here, I’ll just figure out what I’m supposed to do, but she insisted. So I went to try to find the shift leader to find out what to do, and he informed me that I was supposed to be on another unit, which he was also shift leader for, and directed me there. By the time I got there, I was already, as we say in Tennessee, a day late and a dollar short. I found the nurse I was to get report from, who said it had been a horrible day and this was probably the heaviest group on the floor. Wonderful. So I got report and tried to figure out really quickly where things were and how the floor worked. That was harder than expected, as, unlike the unit I’d been pulled to the week before, it was not a particularly friendly place. But I muddled along and did the best I could. I did my assessments, my blood sugars, did my own vital signs because the one CNA on the floor was nowhere I could see, and started my ten o’clock meds. I remembered that I needed to draw labs from one patient so I went to look for the label and couldn’t find it, decided I would have to order and print the label, and was doing so when along came the supervisor. She said the shift leader would be coming to get report on my patients “and you can go home and you can talk to [the manager] in the morning.” I was shocked and upset for a minute and she went on to say that “she wouldn’t have someone in the hospital who didn’t trust her.” ??? Oh well. I knew I had screwed up, made the wrong person mad, and would get my contract canceled. I went downstairs and cleaned out my locker and went on back to my apartment. I probably should have been upset, but I was relieved. I packed up all my clothes before I went to bed and decided I’d do the rest today.

Only today the manager didn’t call me. I thought that was pretty weird, but I assumed that if she hadn’t I should go in to work tonight, so I did. That’s when I learned she had called my agency and terminated my contract. Damn nice of her to call and tell me! But pretty consistent with the lack of class this hospital has shown since I’ve been here.

So what now? Well, for the immediate future, back to what passes for home, regroup, and decide what I want to do next. I’ve pretty much decided to move to Virginia, probably to a city that’s become one of my favorites, but I don’t know if I’ll take a permanent job or travel from there. It might be ideal, at least for awhile, to find a travel position two or three hours from there, get my schedule in a block (pretty easy if you work nights and/or weekends) and come home in between times. But what I’d really like to do is work in a cardiology practice, a stress or electrophysiology lab, or even cath lab. I guess I’d even settle for a cardiology floor if it came right down to it.

Anyway, Merry Christmas, y’all!

Some other things have happened to make me think. A good friend’s brother died in a freak accident, suffering a traumatic brain injury; he was an organ donor and was in good health, and I am told that as a last act, even though it was not a conscious one, he gave “right down to the marrow of his bones.” At almost exactly the same time, I heard from one of my dearest friends in the entire world (literally–he lives in Israel!) that he had been placed on the list for lung transplant and was told that the average waiting time there was 4-6 months. Not that one affected the other, but it seemed an odd coincidence that they happened so close together. Less than two weeks later he was called to the hospital and was actually prepped and waiting for surgery, lying on a gurney with arms outstretched.and when they opened up the putative donor, the lungs were in too bad a condition to use! I got a very funny e-mail from him after that, entitled “Dress Rehearsal Rag,” detailing what went on and what he thought. (With his trademark off-center humor, he described his position on the gurney thus: “They spread my arms out from my body, supported by the arm rests, and attached the IVs etc. to them. And i glanced at myself and thought: Hey fellas, just remember what happened the LAST time they stuck a Jew on a cross.”) Anyway, about 10 days ago he was called to the hospital again, and this time he actually HAD his transplant. He was supposed to be discharged on Thursday, but I have not heard yet from either him, his son (the designated communicator, who gives “taciturn” a whole new meaning) or his erstwhile girlfriend that he is indeed home.

So on to last night, which was busy but not horrendous for me.and was hideously so for my partner, who inherited not one but two from CCU, plus one that I’d had the night before.which was the one giving her fits. When I’d had her she was pretty confused at night and had some issues with her blood pressure, but not totally out of character for a 70-something with a sacral fracture and on some pretty heavy-duty pain meds. Last night, however, was an entirely different story. Apparently through the day she’d had increasing problems with her blood pressure, or as the day crew said “We kept thinking her head would blow off!” and they’d finally decided that since she was also trying to climb out of the bed, the problem was anxiety, and they’d gotten an order for Ativan which chilled her pretty much.until about 8:30, when she woke up and was utterly, totally, and completely bonkers. And then her blood pressure started to climb to unreal levels. At that point something started niggling at the b back of my mind. I’d seen this before.and history of multiple falls recently.do you suppose? So I wondered aloud if she’d been taking something before she came in that had somehow escaped her med list, something like Xanax, maybe.a favorite drug of little old ladies and one that has notoriously nasty withdrawal. Still, the more I looked at her, the more I thought of something else, and I said to my partner, “You know, she looks like the DTs.” My partner didn’t think so at all, and between dealing with that patient’s blood pressure and the correspondingly low pressures of the one in the next room, and the trauma survivor besides, she didn’t really have time to think about it. I didn’t say anything more, but the thought didn’t leave my mind. Meanwhile, the patient’s blood pressure kept climbing, her anxiety level kept rising, she had tremors, and her behavior became more and more bizarre. All meds to control the blood pressure were proving useless, and when the patient became sweaty and wheezy, she called the doctor. Of course it was the on-call, and she had to go into the history, but he asked one very pertinent question: could she be in withdrawal? While we waited for him to come up, we went into her room and she asked her a few pointed questions, like did she drink and how much and what. We got some confused answers, but enough to make us conclude that this might just be the problem. And when the doc came up, he took one look at her and said in his Chinese-accented English, “Yep, she is in DTs.” From then on it was pretty straightforward detox orders.ativan, banana bag (IV with multi-vitamins, so called because of the yellow color of the fluid), B vitamins, etc. She chilled out.and didn’t her blood pressure come down?

I guess people don’t think of little old ladies having drinking problems. Nobody probably thinks anything of granny’s nighttime glass of wine; hell, my own grandma had her *one* glass of Mogen David before bed every night of her life, though she would have been quite offended if anyone had offered her a second. But alcohol can be anyone’s problem. I lived with it for a long time, and worked at one time in a unit where, if we didn’t have two or three drunks or druggies detoxing, we just weren’t living right, so maybe I just picked up on it. Did I feel vindicated? Yes. Did I gloat? No, because I have missed things that should have been obvious, and I will again. Still, it feels good to know you’re right now and then.

Monday I received a call from the nurse manager of the Chest Pain Unit in the City Up The Road. We talked a bit and she wanted to know how soon I could start I told her I *thought* I could start Oct. 29, which was the following Monday, but if not, I could definitely come on board the Monday after. I immediately e-mailed my recruiter, and she called me right back, saying she’d already heard from the hospital, and she could get me there by the 29th. Since then, it’s been non-stop e-mails, one FedEx delivery, multiple faxes, phone calls, and more e-mails! Today I stopped just short of saying, “Hon, why don’t you just get YM and save us all this trouble?” But it looks like I will indeed be starting there on Monday. Packing is not a huge deal, as I barely unpacked last time, and the fact that it’s just about an hour from here means I can actually make multiple trips to retrieve anything I might need. I’ll have to do the extended stay thing for the first few days until my apartment is ready, but I should be able to be in the apartment by Wednesday night.

Yesterday I had to drive to Knoxville for my drug screen. Now, normally that wouldn’t be a big deal, but this agency only uses one chain of labs, so I had to go there, and they wanted results before Friday, so I had to go then. All of which was fine, except that when I got there the place was packed. Seems a local company had sent their entire stable of new employees over for the same purpose, and they had all got there and signed in just before I did. I had prepared for the drug screen like a good little girl, which meant that I already needed to pee when I got there. By the time they got to me, I could have given them 4 or 5 samples and still had a good bit left over! But that got another thing on the list checked, and I’m that much more ready to go. I am definitely ready to get started again; a small amount of vacation is nice, but a paycheck is even nicer!